Field of the Invention
This invention relates to bone fractures and, more particularly, to a plate and inserter combination that can be used to operatively place and secure the plate at a desired location at a fracture.
Background Art
Minimal insertion surgery, or MIS, is a technique in which a plate is inserted along the surface of a bone through a small incision. The surgeon first makes a limited incision and dissects down to the bone surface, and then uses an instrument to dissect through soft tissues for a distance far enough to produce a channel to accept the plate length desired. Once this is done, a plate is applied through the limited incision and fixed with fasteners placed percutaneously through the plate holes. The plate serves to stabilize the bone on each side of the fracture, to minimize motion between the bone ends to promote healing. In addition, often the plate functions to hold ends to promote healing. In addition, often the plate functions to hold opposing bone ends apart, thereby preventing shortening of the bone. Structural rigidity of the construct is improved if the plate is close to or at the bone surface.
Consequently, multiple steps must be serially performed with multiple instruments to complete the plate placement and its securement. The size of the instrument used to create the soft tissue channel may not be the same as the size of the plate that is inserted; this can create difficulties with passage of the plate. Furthermore, since the dissecting instrument needs to be removed prior to introduction of the plate, soft tissues may drop into the path created by the instrument, further obstructing placement of the plate or causing the plate to be guided in a different path than intended. Passage of the plate into correct position may also be awkward since the surgeon is required to hold the end of the plate with his/her fingers and push in lengthwise, or try to hold the end of the plate with a clamp to control the plate during insertion. In the latter situation, the clamp may not securely hold the plate, causing it to uncouple or misdirect the orientation. Because of this potential, the clamp is generally held in place with sufficient force that it may scratch or damage the surface of the plate/implant. Further, the initial incision has to be made large enough that the plate insertion can be readily carried out without significant interference from tissue at the site.